Ofcom application form OfW512 Application to permit an existing licensee to undertake spectrum leasing For applying for a variation to a Wireless Telegraphy Act licence to allow the holder to lease spectrum in accordance with section 30 of, and schedule 1 to, the Wireless Telegraphy Act 2006 as amended www.ofcom.org.uk General guidelines on Ofcom’s policies and procedures relating to spectrum leasing can be found in the document Trading Guidance (OfW513). Applications cannot be progressed unless the form is signed by someone who is authorised by the licenceholder to act on its behalf. This form is to be used to apply for a licence variation that will enable you to undertake spectrum leasing. Leasing is a form of trading in which you, as the licence-holder, let someone else exercise your licence rights to use the spectrum subject to the terms and conditions of your licence and any additional restrictions that you impose in the lease contract. The leaseholder will not hold a licence from us but will be allowed to access the spectrum by virtue of the lease contract. There is another form of spectrum trading (known as ‘transfer’) in which the person acquiring the rights receives a separate licence from us. If you wish to undertake a transfer, please use form OfW 206 or OfW437. For further information about leasing and transfer, see OfW513 Print clearly. Illegible, unclear or incomplete application forms may delay processing. Completed forms should be forwarded to: Ofcom Spectrum Trading Desk Riverside House 2a Southwark Bridge Road London SE1 9HA Licensee Name Licence Product Licence number(s) If the number of licences for which the licensee wishes to be authorised to undertake leasing exceeds the space above, additional details should be provided on a separate sheet of paper and attached to this form. Page 2 of 3 Declaration The licence holder (and each concurrent licence holder, if any) hereby confirms that it has read and agrees to comply with the obligations and requirements set out in the variation and accepts responsibility for complying with them, in particular the obligation to keep records of leases granted and to make specified information available to Ofcom on request. The licence holder (and each concurrent licence holder, if any) hereby confirms that it has not requested Ofcom to revoke or vary the licence where that revocation or variation has not yet been made. The licence holder (and each concurrent licence holder, if any) hereby warrants that it consents to the variation to permit leasing for the licence(s) detailed in this application. The licence holder (and each concurrent licence holder, if any) indemnifies and holds harmless Ofcom from and against any loss, liability, damages, expenses or costs (including legal costs and expenses on a solicitor/client basis) arising in connection with any inaccurate or misleading information contained in this application or with its consent to the variation. Signed for and on behalf of the licence holder Full name (block capitals) Job title or role Contact Tel: Email Date Concurrent licence holders Each concurrent licence holder must sign this form. A director or authorised person must sign for public limited companies and other legal entities. Ofcom will however, address all correspondence to the primary contact above. Signed for and on behalf of each concurrent licence holder Full name (block capitals) Date Ref: Ofw.512/Fol.171_11/11 Page 3 of 3
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